Chickenpox (varicella)

There is no treatment for chickenpox. People usually get better with rest and paracetamol to help with pain and fever. People who are very sick might need to go to hospital.

It is important to not scratch the rash as this can cause skin scarring or infection. To help with the itch you can:

• rest while unwell
• have a lukewarm bath with baking soda, oatmeal or an anti-itch solution (e.g. pinetarsol) added to the water
• apply creams or lotions such as calamine lotion to the skin
• take paracetamol to reduce fever or discomfort.

Aspirin must not be given to young children and adolescents due to the risk of developing a severe condition called Reyes Syndrome. This is important for children who have or who may be developing chickenpox.

Chickenpox is passed on by coughing, sneezing, saliva or contact with the fluid in the blisters of the rash.

Chickenpox can also cause shingles (herpes zoster) in later life. A person who has never had chickenpox can get chickenpox from someone who has shingles.

A person with chickenpox can make others sick from 1 to 2 days before the rash starts until all of the blisters have scabbed over, usually 4 to 5 days. The usual time between contact with the virus and developing chickenpox is about 14 to 16 days, sometimes it can take longer.

People with chickenpox should be excluded from childcare, school, or work for at least 5 days and until all blisters have dried and turned into scabs.

If you have chickenpox you can help stop the spread by washing your hands often and covering your cough or sneeze. It is very important to stay away from people who are at risk of serious disease.

Immunisation

There are safe and effective vaccines for chickenpox. Some vaccinated people will still get chickenpox (breakthrough varicella), however the illness and rash are milder.  The fluid in the skin lesions in breakthrough varicella can be contagious.

Children are recommended to have 2 chickenpox vaccines. A combined measles, mumps, rubella and varicella (MMRV) vaccine is provided free to children at 18 months of age. A history of chickenpox is not a contraindication to this vaccine and can be safely given. The second dose is not provided free under the National Immunisation Program. Parents can discuss this and any costs with their vaccine service provider.

Adolescents over the age of 14 and adults should have a record of 2 doses of the varicella vaccine at least 4 weeks apart or a history of chickenpox.  If there is uncertainty whether a person has had chickenpox, it is safe to have the vaccine. Queensland Health provides a funded varicella vaccination to non-immune people, refugees and humanitarian entrants of any age.

Vaccination is highly recommended (but not provided free of charge) for non-immune people at high risk of chickenpox:

• high-risk workers where contact with chickenpox is likely (eg. healthcare workers, teachers, childcare staff)
• women planning a pregnancy (chickenpox vaccine should not be given during pregnancy and women are advised to avoid becoming pregnant for 28 days after vaccination)
• women immediately after delivery of a baby
• parents of young children
• household contacts of people with weakened immune systems

All vaccines can have side effects, but most are not serious. Some people can have pain where the needle was given, fever, a rash or feel tired. Side effects usually happen within 10 days of the vaccine and only last a few days. Very rarely, some people can have a serious allergic reaction.

Sometimes after chickenpox vaccination, a mild chickenpox-like rash may appear at the injection site or on the body. People with this rash should avoid contact with people with weakened immune systems and pregnant women.

Talk to your doctor if you or your child have symptoms after a vaccine which you are concerned about.

Varicella vaccine can protect a non-immune person if given within 5 days of exposure to chickenpox.

Zoster immunoglobulin (ZIG) containing varicella antibodies can be offered to persons at high risk of serious chickenpox disease. This must be given within 96 hours of exposure to chickenpox. ZIG is not a chickenpox treatment.

Women who are planning pregnancy

Women planning a pregnancy should check with their doctor if they are immune to chickenpox. Women who are not immune require 2 doses of a varicella vaccine a minimum of 4 weeks apart and should avoid pregnancy for at least 28 days after immunisation. Women who are not immune and are already pregnant should not have a varicella vaccine and arrange for vaccination soon after they have their baby.

Pregnant women who think they have been in contact with chickenpox should see their doctor.  If a woman develops chickenpox during pregnancy, there is a small but serious chance of damage to the baby.

For further information, contact your local doctor, health centre or nearest public health unit. You can also call 13 HEALTH (13 43 25 84) 7 days a week at any time.